MASSIVE LIFE-THREATENING SUBCUTANEOUS EMPHYSEMA: A MANIFESTATION OF TRACHEOBRONCHIAL INJURY

Received 2020-11-10; Accepted 2021-06-02; Published 2021-09-20

Authors

  • Chui King Wong Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
  • Glen Chiang Hong Tan Emergency and Trauma Department, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
  • Mohd Johar Jaafar Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

DOI:

https://doi.org/10.22452/jummec.vol24no2.10

Keywords:

Pneumomediastinum, Pneumothorax, Subcutaneous Emphysema, Tracheobronchial injury

Abstract

Subcutaneous emphysema, a known complication of tracheobronchial injury (TBI), is usually a self-limiting condition, but occasionally, a massive one can become life-threatening. We present a patient with TBI who developed massive subcutaneous emphysema with bilateral pneumothorax causing hemodynamic instability. Upon arrival to the hospital, the patient required emergent intubation for impending respiratory collapse. Bilateral thoracostomy tubes were inserted, resulting in hemodynamic improvement. Emergent CT thorax showed a tracheal-oesophageal injury just distal to the cuff of the endotracheal tube (ETT) at the level of the third thoracic vertebra (T3). Despite surgical repair and intensive care, the patient succumbed after a week in ICU due to ventilatory failure. This case report highlights the importance of the initial management of TBI requiring rapid identification and airway management.

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Published

2021-09-20

Issue

Vol. 24 No. 2 (2021)

Section

Research article

License

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